Provider Demographics
NPI:1750791604
Name:VAUGHAN, KRISTI (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 KALMUS DR STE E130
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7989
Mailing Address - Country:US
Mailing Address - Phone:714-434-9355
Mailing Address - Fax:714-441-9323
Practice Address - Street 1:151 KALMUS DR STE E130
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7989
Practice Address - Country:US
Practice Address - Phone:714-434-9355
Practice Address - Fax:714-441-9323
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009287111N00000X
CADC32920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor